ABSTRACT/SUMMARY Germstravelandgermschange?toavoid,contain,orbesttreattheworld'sinfectinggermsandtheirresistancegenes weneedtoknowwheretheyareandwherethey'regoing.Allwecanknowaboutthespreadofmicrobestoavoidor containthemmustcomefromtheworld'smicrobiologylaboratories,theonlyplacesthatseethem.Repurposingthe routinepatientreportsoftheworld'smicrobiologylaboratoriesintoacomprehensivesystemforglobalsurveillanceof infectingpathogenswillthusmakeinfectionseasiertoavoid,treat,andsurvive.Itwilllocateeachpatient'sinfection withinevolvingglobalandlocalepidemicsofinfectingmicrobesthatonlyallthereportstogethercansee. BigDatacanintegratethedataoftheworld'stensofthousandsofmicrobiologylaboratoriestodetect,track,and containsuchepidemicclonessooner.Itcandiscriminatethembyroutineantimicrobialresistancetestresultsand furtherbyselectivetyping,nowbynucleotidesequencing.Automatedearlydetectionofacommoncloneatacenter canalertitsinfectioncontrol,andatmultiplecentersboththeirsandthepublichealthagencyfortheregion.Such controlisincreasinglyurgent.TheU.S.CentersforDiseaseControlandPreventionestimatesresistantpathogenscause over23,000deaths/yearintheUnitedStates.Itisworseinmuchoftheworldwithmoreresistance,fewerantibiotics andlesscontrolovertheiruse.TheWorldEconomicForumestimatesgrossdomesticproductlossesfrom0.4%to1.6%. Theaggregateenormouslyrichdataoftheworld'smicrobiologylaboratories,however,arenowlargelyinaccessible, under?interconnected,under?analyzedandunderutilized.Ourcenter,theWorldHealthOrganizationCollaborating CentreforSurveillanceofAntimicrobialResistance,hasfordecadesgivenmicrobiologylaboratoriesfreesoftware, WHONET,totranslatetheirdiversefilesintointeroperable,standardizeddataforanalysisandformergerinto surveillancenetworks.WHONETisusedin>2300laboratoriesin>110countriessupportingnationalandinternational networksincludingReLAVRAofthePanAmericanHealthOrganization,theEARS?NetnetworkoftheEuropeanUnion, andtheGlobalEmergingInfectionsSurveillance(GEIS)programoftheU.S.DepartmentofDefense. Thisprojectwillbuildonlong?standingcollaborationsbetweenWHOCollaboratingCentreforSurveillanceof AntimicrobialResistance,WHONET?Argentina,theWellcomeTrustSangerInstituteCentreforGenomicPathogen Surveillance,andPublicHealthEnglandColindale.NewBigDatatoolswillupgradeWHONETtoarelationaldatabase schemawithcloud?basedstorage,securepatientandfacilityconfidentiality,andsynchronizationwithnational databases.Newmulti?levelalgorithmsbuiltontheconceptof?phenotypicstrain?recognitionandtrackingwilldetect andalertresponderstoimpendingproblemstoimprovepatientsafety,andthusincentivizeextendingsurveillancetoall oftheworld'smicrobiologylaboratoriesfurtherenhancingitsgranularity.Thenewplatformwillintegrateresistance andstraintypegenefindingsmadepossiblebyrapidadvancesinwhole?genomesequencingtechnologiesandsequence processingpipelinestosupportcontextualreportingtocliniciansandpublichealthauthoritiestosupportpatientsafety andresistancecontainment.